Since the mid-1980s, Canada's social security system has been undergoing a profound transformation. Virtually every major social program has been or is in the process of being changed. The pension system is no exception: every element of Canada's complex retirement income system, both public and private, has been altered in some manner, in some cases profoundly. This paper analyses the various changes to Old Age Security and other elderly benefits under the Mulroney and Chrétien governments, culminating in the new Seniors Benefit. The Conservatives used “social policy by stealth” to make significant changes to elderly benefits, paving the way for the Liberals' plan to rationalize programs into a single income-tested Seniors Benefit. Arguments for and against the Seniors Benefit are considered. The Canada Pension Plan also is under scrutiny by the federal and provincial governments, which are considering two routes to reform — a move from paygo to partial funding, including a more rapid ramp-up in contribution rates, and various options to trim benefits.

As part of its recruitment process, the Canadian Longitudinal Study on Aging (CLSA) will face the challenge of screening out individuals who are sufficiently impaired in their ability to provide informed consent. In the process of developing the design of the CLSA, a review of the literature was performed with the goal of identifying currently existing telephone cognitive screening tools that can be used to identify eligible study participants for population-based research on aging. We identified 12 telephone screening tools, four of which were based on the Mini-Mental State Exam (MMSE) and eight that were based on other face-to-face screening tools. Characteristics – including the constructs measured, the length of time for administration, the scoring/classification scheme, and any information regarding the validation of each tool – were extracted and summarized.

This study documented the provision of services and issues experienced by community organizations supporting older adults and caregivers in the province of Quebec during the coronavirus disease (COVID-19) pandemic, as well as promising strategies to adapt the provision of services in this context. A cross-sectional electronic survey using open- and closed-ended questions was conducted in July 2020. Almost three-quarters of the 307 respondents (71.4%) reported having maintained services at least partially throughout the lockdown, and the majority (85.3%) adapted their services. Among key challenges, participants reported difficulties identifying and supporting older adults at greater risk of vulnerability (54.8%), managing health risks for service users (60.2%), and recruiting volunteers (59.5%). Promising strategies included strategies to reach out to older adults and understand their needs (e.g., systematic phone calls) in addition to direct interventions supporting them (e.g., activities promoting social ties); implementing prevention and protection measures; accessing and using technologies; human resources management (e.g., recruiting new volunteers); finding financial support for their organization; developing intersectoral partnerships (e.g., multisectoral crisis cell); and promoting a positive view of older adults. The integration of multiple perspectives from different stakeholders may help identify strategies potentially transferable to other crises in order to meet older adults’ needs.

Several determinants of developing fear of falling (FoF) overlap with the consequences of diabetes mellitus (DM). We compared the prevalence and severity of FoF in older adults with and without DM and identified which FoF determinants contribute to FoF severity in older adults with DM. We used Canadian baseline data from the International Mobility in Aging Study (IMIAS) which identified 141 older adults with DM (DM-group;age:68.88±2.80years) and 620 without DM (noDM-group;age:68.81±2.68years). FoF was quantified with Falls Efficacy Scale–International (FES-I). FoF determinants were evaluated in demographic/health-related, physical, psychological, and social domains. High concern of FoF was more prevalent and of higher severity in 10/16 FES-I activities in the DM-group compared to the noDM-group. Higher FoF severity in the DM-group was associated with poor physical performance, being female, fall history, and clinical depressive symptoms. Protocols developed for screening and interventions may reduce FoF severity in this population.

This study investigated the state of gerontology content in health and social service education programs in Ontario, and readiness indicators for change among administrators and faculty. We conducted a survey of teaching faculty (n = 100) and deans or directors (n = 56) of 89 education programs, which revealed mixed evidence on readiness for change. Most respondents thought their programs were adequate but needed enhancement. However, they were unaware of published gerontological competencies with which to evaluate their curricula. Beliefs about capacity for change varied, with half the participants indicating that their programs had sufficient faculty expertise in gerontology and geriatrics. Factors influencing readiness for change include lack of gerontological expertise; need for institutional and management support; need for additional teaching resources; and recognizing the need for change. There is an opportunity, by committing resources and time, to capitalize on the faculty and administrators who thought their programs should improve.

Research measures can be integrated into routine care if they are useful to care providers. Measures will be useful if they facilitate the processes of care, and if the outcomes which they measure reflect outcomes of importance to the patient. Many current measures suffer from being unwieldy for routine use, or not adequately measuring relevant outcomes. In the care of the frail elderly, who have complex needs, these challenges are particularly difficult. The techniques of Comprehensive Geriatric Assessment and Goal Attainment Scaling (GAS) are proposed as means of embracing the complexity of the needs of the frail elderly, and measuring the effectiveness of specialized interventions. GAS appears to meet the current definition of a Health-Related Quality of Life measure, suggesting that its routine use provides advantages both as a management process and as an outcome measure.

Les compagnons rémunérés, fonctionnant d’une façon autonome ou par le biais des agences privées de soins à domicile, effectuent une variété de services pour les personnes âgées nanties qui peuvent se payer pour le soutien privé dans leurs maisons et dans les centres qui dispensent tels soins. Cette étude a examiné le travail accompli par les compagnons rémunérés, en s’appuyant sur des entretiens semi-structurés, ouverte, des entrevues en personne et d’élicitation des photos auto-pilotées (par lequel les individus prennent leur propres photos et en discuter plus tard dans les entretiens) avec 30 participants (15 compagnons, 8 clients et 7 informateurs clés). Les résultats ont révelé que, de plusieurs façons, les services fournis par les compagnons pour les clients qui vivent dans leurs propres maisons ressemblent aux soins à domicile basés sur les tâches, mais l’accent mis sur le travail est différent. Les relations sociales et émotionelles avec les clients sont au centre de leur travail. Les compagnons basés dans les établissements jouent un rôle unique, remplissant le vide laissé par les compressions budgetaires des ratios de dotation en personnel, qui garde les résidents âgés, souvent atteint de démence, impliqués et engagés dans le monde.

Our primary objective was to understand the barriers and facilitators associated with the implementation of high-quality clinical practice guidelines (CPGs) for depression and anxiety in patients with dementia or Parkinson’s disease (PD). We conducted focus groups or interviews with participants experiencing dementia or PD, their caregivers, and physicians in Calgary, Alberta, and applied the theoretical domains framework and behaviour change wheel to guide data collection and perform a framework analysis. Thirty-three physicians and seven PD patients/caregivers participated. We report barriers and facilitators to the implementation of guideline recommendations for diagnosis, management, and the use of the guidelines. An overarching theme was the lack of evidence for depression or anxiety disorders in dementia or PD, which was prominent for anxiety versus depression. Patients noted difficulties with communicating symptoms and accessing services. Although guidelines are available, physicians have difficulty implementing certain recommendations due primarily to a lack of evidence regarding efficacy.

The Functional Transitions Model (FTM) integrates the theoretical notions of progressive functional decline associated with Alzheimer's disease (AD), excess disability, and transitions occurring intermittently along the trajectory of functional decline. Application of the Functional Transitions Model to clinical practice encompasses the paradox of attempting to minimize excess disability while anticipating the progressive functional decline associated with AD. It is suggested that times of functional transition are times of decision making and opportunities for interdisciplinary collaboration to identify and minimize excess disability, for revision of goals and expectations, and for provision of support to patients and caregivers. The model also is applicable as a conceptual framework for education and research.

This paper discusses different dimensions of social support which can be examined in the context of family care of the elderly. It calls for a greater measure of theoretical and empirical precision in relating specific types and sources of actual and perceived support to the particular demands and burdens faced by family caregivers at different stages in the course of caregiving. In addition, it spotlights three critical topics for future research: (1) analysis of the ways in which social support affects and is affected by chronic stressors; (2) examination of the determinants of actual and perceived support; and (3) the design and evaluation of interventions aimed to mobilize or augment the support provided to family caregivers.

This paper examines the social networks and patterns of social interactions of two relatively neglected marital status groups of elders, namely the ever-single and the separated/divorced. Drawing on data from the 1985 General Social Survey conducted by Statistics Canada, comparisons are made both between and among the 224 ever-single and 126 separated/divorced Canadians aged 65 and over. When controlling for age, gender, education and health status, ever-single individuals tend to have smaller family networks, a similar number of friends, and similar living arrangements as the separated/divorced. In-person contact with siblings is significantly associated with being ever-single while no differences emerge for contact with other relatives or with friends. Differences among the ever-single and among the separated/divorced are also assessed.

Based on data from a random sample of foreign-born Chinese elders (n = 708) interviewed in Vancouver and Victoria in 1995–96, this paper examines the extent, determinants, and consequences of ethnic identification. Of the respondents, who have a median age of 75 and a median age at immigration to Canada of 55, 49.3 per cent stated that they felt more Canadian than Chinese, 36.6 per cent felt more Chinese, and 14.1 per cent felt equally Chinese and Canadian. Logistic regression analysis is performed, in an attempt to discover the determinants of Chinese ethnic identity. Significant independent variables include: place of residence, age, years since immigration, English-speaking ability, and personal monthly income. Consequences of retention of Chinese ethnic identity are explored, in terms of religious affiliation, health-related behaviours, family variables, and well-being variables. Only well-being is affected by retention of Chinese identity, an effect that is negative and felt largely by women only.

We examined the relations between perceived health (e.g., self-perceived health status) and driving self-regulatory practices (e.g., frequency of driving, avoiding challenging driving situations) as mediated by driving attitudes and perceptions (i.e., driving comfort, positive and negative attitudes towards driving) in data collected for 928 drivers aged 70 and older enrolled in the Candrive II study. We observed that specific attitudes towards driving (e.g., driving comfort, negative attitudes towards driving) mediate the relations between health symptoms and self-regulatory driving behaviours at baseline and over time. Only negative attitudes towards driving fully mediated the relationships between changes in perceived health symptoms and changes in driving behavior. Perceived health symptoms apparently influence the likelihood of avoiding challenging driving situations through both initial negative attitudes towards driving as well as changes in negative attitudes over time. Understanding influences on self-regulatory driving behaviours will be of benefit when designing interventions to enhance the safety of older drivers.

During large-scale crises such as the COVID-19 pandemic, the precarity of older people and older volunteers can become exacerbated, especially in under-serviced rural regions and small towns. To understand how the pandemic has affected “older voluntarism”, this article presents a case study of three volunteer-based programs in rural Ontario, Canada. Interviews with 34 volunteers and administrators reveal both challenging and growth-oriented experiences of volunteers and the programs during the first wave of COVID-19. The findings demonstrate the vulnerability and resiliency of older volunteers and the adaptability and uncertainty of programs that rely on older voluntarism, as the community and its older residents navigate pandemic-related changes. The article advances a framework for understanding the pandemic’s impacts on older voluntarism in relation to personal, program, and community dimensions of sustainable rural aging. Further, it explores ways that older volunteers, organizations that depend on them, and communities experiencing population aging can persevere post-pandemic.

This research broadens the understanding of the relationship between paid work and caregiving by including the contribution of the older “care recipient”. Using selected aspects of social exchange theory and a life course perspective, the importance of giving and receiving for caregivers and care recipients is explored through analyses of focus groups with employed women and interviews with their older mothers. The mothers and daughters focus on the time when they are most indebted to each other. The daughter's employment affects the type and value of contributions from care recipients. The mother's past assistance with housework and caring for children is greatly valued by the daughters. For care recipients, however, being reliant on a busy employee for their care has negative consequences. The mothers emphasize the current situation and under-estimate their past helping. Further research should consider the care recipient's perspective to obtain a broader understanding of the impact of the caregiver's employment in caregiving relationships.

In this study, we examine trends in the patterns of time use of seniors in Canada since the 1980s. In particular, we ask whether today's seniors devote more, or less, time to productive activities than 20 years ago. Our inquiry is motivated by the claims that today's seniors are not engaged in ‘active aging.’ This study uses data from a series of time-use surveys carried out in Canada since 1981 to empirically test the validity of this claim. Our results suggest that some shift towards active aging has taken place in Canada since the 1980s; however, this shift involves a complex pattern of reallocation of time that varies by gender and age.

A total of 59 bereaved elderly persons and 20 married elderly persons were asked to complete a series of questionnaires on depression, anxiety and well-being. The bereaved elderly persons were divided into three groups based on the length of time elapsed since the death of the spouse. The results showed that bereaved subjects were more depressed and anxious and that their well-being was generally inferior to their married counterparts; further, their emotional reactions persisted after many months of mourning and finally some of the bereaved seemed more at risk than others. These issues should be examined more thoroughly using longitudinal studies.

Research on video games’ effect on cognition and behaviour has been extensive, yet little research has explored non-digital forms of game playing, especially among older adults. As part of a larger survey on game playing, 886 respondents (≥ age 55) filled out questionnaires about non-digital game play. The study aims were to determine perceived benefits of non-digital game play and to determine socio-demographic factors that might predict perceived benefits. Survey results indicate that non-digital game playing is social in nature and common (73% of respondents) among older adults. Older adults play for fun, but also to help maintain their cognition. Regression analyses indicated various socio-demographic factors – age, education, gender, and race – were independently associated with perceived benefits from game playing. The results thus emphasize the importance of non-digital game playing in this population and suggest that efforts to facilitate game playing may improve social interactions and quality of life.

The aim of this study was to better understand care protocol implementation, including the influence of organizational-contextual factors on implementation approaches, in long-term care homes operating in Ontario. We surveyed directors of care employed in all 547 Ontario LTC homes, and combined survey data with secondary organizational data on rural/urban location, nursing home size, chain membership, type of ownership, and accreditation status. Motivations for the use/selection of care protocols in nursing homes primarily derived from beliefs in continuous improvement and in evidence-based care. Protocol selection was largely participative, involving management and staff. External information sources were important for protocol implementation, and in-service education was the chief means of training and educating staff. Significant differences in approaches to implementation were evident in association with differences in ownership. Three key success factors for implementation were identified: contextualizing the practice change, adequately resourcing for implementation, and demonstrating connections between practice change and outcomes.